October 2007 - Posts

• Case of the Week - Case # 49

  A 39-year-old male presents to the ED with a swollen left ankle.  He states he was bit by his cat two days ago and has noted progressive pain and redness.  On examination, the patient is febrile at 38.4 C and his exam reveals extensive erythema over the ankle with several puncture wounds noted medially.  You consult the ortho service due to your concern that the patient has more than a simple cellulitis.  The ortho resident tells you this is "just a cellulitis" and tells you to admit the patient to medicine.  You perform a bedside ultrasound and note the following... Take the Case Posted Oct 30 2007, 01:00 AM by Rob with no comments Filed under: Intermediate, Musculoskeletal

• Case of the Week - Case # 48

  A 26-year-old female who is 9.5 weeks pregnant by dates presents with right flank pain and vomiting.  She denies fever, chills, hematuria, vaginal bleeding.  Other than being pregnant, her PMH is unremarkable.  On examination she appears mildly dehydrated but her vitals are stable. You are concerned that this patient has a kidney stone.  You perform a bedside ultrasound and note the following... Take the Case Posted Oct 24 2007, 02:27 PM by Rob with no comments Filed under: Renal, Beginner, OB

• Case of the Week - Case # 47

  28-year-old male with ESRF on HD presents with bilateral flank pain and concern for obstruction.  Pt states his renal failure is due to childhood obstruction due to posterior urethral valves.  He believes that his last CT scan showed small kidneys but no evidence of obstruction.  The patient appears comfortable on the cart.  His vitals are stable and he is afebrile.  His urinalysis reveals no evidence of hematuria or pyuria.  Take the Case Posted Oct 15 2007, 01:39 AM by Rob with no comments Filed under: Renal, Intermediate

• Case of the Week - Case # 46

  A 22-year-old male presents to the ED after having been shot in the left chest during an attempted carjacking.  The bullet entered into the left chest just medial to the left shoulder.  Initially, the patient was awake and alert with BP 124/64, HR 92 and RR 16.  His chest xray revealed several bullet fragments in the left chest and one fragment in the right chest.  The cardiac silhouette was normal.  His blood pressure subsequently decreased to 82/54.  You perform a FAST exam (his abdominal windows were negative and thoracic windows demonstrated no evidence of a pneumothorax) and note the following: Take the Case Posted Oct 07 2007, 11:41 PM by Rob with no comments Filed under: Intermediate, Cardiac